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A novel transverse ultrasonography technique for minimally displaced lateral humeral condyle fractures in children. | LitMetric

AI Article Synopsis

  • The management of minimally displaced lateral humeral condyle fractures in kids is debated due to challenges in assessing the stability of the cartilage hinge using current imaging methods.
  • A study was conducted on 39 pediatric patients to evaluate the effectiveness of transverse ultrasonography in determining the integrity of the cartilage hinge for guiding treatment decisions.
  • Results showed that patients with intact cartilage hinges successfully healed with conservative treatment, whereas those with disrupted hinges required more interventions, highlighting the potential of ultrasound as a reliable tool in this context.

Article Abstract

Introduction: Management of minimally displaced lateral humeral condyle fractures in pediatric patients is controversial. This is primarily because with current imaging modalities it is difficult to accurately and conveniently determine the stability of the fractures by detecting the integrity of the cartilage hinge. Nevertheless, transverse ultrasonography has not been intensively reported in previous studies.

Hypothesis: Transverse ultrasonography can determine the integrity of the cartilage hinge in minimally displaced lateral condyle fractures.

Materials And Methods: We retrospectively reviewed the medical records of 39 pediatric patients with minimally displaced fractures of the lateral humeral condyle who underwent transverse ultrasonography between 2014 and 2017. Conservative treatment was given to pediatric patients with intact cartilage hinges that had been confirmed by transverse ultrasound images. Surgical treatment was recommended for pediatric patients with disrupted cartilage hinges. Data regarding healing of the lateral humeral condyle fractures were recorded and analyzed.

Results: According to transverse ultrasonography, there were 14 children with intact cartilage hinges and 25 children with disrupted cartilage hinges. Fourteen children with intact cartilage hinges of the fracture were treated conservatively, and none of them showed secondary displacement. There were 16 children in whom there was surgical intervention, and 9 other children decided to have conservative treatment among the 25 children with disruption of the cartilage hinge. Five of these 9 children who underwent conservative treatment were found to have further displacement during an average of 12.6 days after the fracture event, and no other patient was found to have further displacement.

Conclusion: Transverse ultrasonography can simply and accurately determine the stability of minimally displaced lateral condyle fractures without sedation, ionizing radiation or invasive techniques. We recommend routine use of transverse ultrasonography to detect stability of the fractures, which can effectively avoid inadequate treatment and unnecessary surgery in pediatric patients with minimally displaced fractures of the lateral humeral condyle.

Level Of Evidence: IV, retrospective cohort study.

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Source
http://dx.doi.org/10.1016/j.otsr.2019.02.005DOI Listing

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